Using and Undertstanding Your Fertility Medication
Whether you are undergoing IVF or needing assistance with ovulation, fertility medications will likely be a part of your treatment plan. It is important to understand how these medications work, what effects they can have, and how to administer them properly. The following types of fertility medications are commonly used to help overcome the obstacles of achieving pregnancy:
Clomid and Letrozole
Usually, the first type of fertility medication administered to patients is oral tablets of clomid or letrozole. This is because of its low impact on the body and minimal side effects. Both work by assisting the development of follicles and the ripening of the eggs within.
Side effects of clomid and letrozole are milder than injectable medications. Patients may experience headaches, bloating, cramping, and mood swings. There is a risk of a multiple pregnancy, but it is less than the risk associated with other types of fertility medication. Your team will counsel you if there is a known chance of multiples.
Gonadotropins, such as Follistim® or Gonal-f®, are a family of fertility medications that replicate or contain follicle-stimulating hormone (FSH). Unlike clomid which induces the body to produce more of its own FSH, these drugs directly affect the ovaries, stimulating multiple follicle development. Additional medication will need to be administered to trigger the final maturation and release of the eggs.
Gonadotropins are commonly used during IVF treatment to maximize the number of eggs that can be collected for fertilization. They can also be administered to induce follicular development if clomid has been ineffective.
Side effects of this type of fertility medication may include bloating, weight gain, and abdominal soreness. There is also an increased risk of multiple pregnancies and some potential for ovarian hyperstimulation syndrome (OHSS).
Human Menopausel Gonadotropin
Human menopausal gonadotropin (hMG), packaged as Menopur®, contains both follicle stimulating hormone (FSH) and luteinizing hormone (LH). It may be used to induce follicle development and ovulation instead of the typical gonadotropin and hCG treatment.
Human Chorionic Gonadotropin
Luteinizing hormone (LH) is normally released at the end of the oocyte maturation process to assist in ovulation, causing the egg to be released from the ovary. To ensure proper timing of ovulation, your team will let you know when this medication is to be introduced.
Human chorionic gonadotropin (hCG), can be labeled as the fertility medication Ovidrel®, Novarel®, or Pregnyl® it is the most commonly used LH simulator. It is given in a single injection at the end of an ovulation induction cycle and should be followed within 24 to 48 hours by artificial insemination, intercourse, or egg retrieval for IVF. Because hCG is the hormone that is detected by at-home pregnancy tests, it is possible to have a false positive after receiving an injection of this fertility medication. Only a laboratory blood test that measures the quantity of hCG in a patient's system can be considered an accurate detection of pregnancy with this type of treatment.
In a natural cycle, once ovulation has taken place, the empty follicle (known as the corpus luteum) begins to release progesterone into the system. This helps to thicken the uterine lining in preparation for implantation and provides support for the early embryo, should pregnancy occur.
When an egg retrieval procedure follows a course of fertility medication, the corpus luteum does not provide the necessary progesterone. It is therefore necessary to give supplemental progesterone after the egg retrieval until it is determined that pregnancy has not occurred or until a pregnancy is established and the body begins producing its own progesterone.
Lupron can come in a few different preparations: multi-dose vial and single dose. A single dose of Lupron can be used as your “trigger” medication in replacement of HCG when there is a concern about potential OHSS or in high-responding patients. Lupron multi-dose vial is commonly used in IVF or Embryo transfer cycles to suppress your stimulating hormones to reduce the risk of early ovulation.